Intractable hiccup and nausea (IHN) was found in eight of 47 cases of relapsing neuromyelitis optica (NMO) (17%) but in none of 130 cases of multiple sclerosis (MS). IHN resolved with methylprednisolone. In six cases, MRI detected linear medullary lesions involving the pericanal region, the area postrema, and the nucleus tractus solitarius. Like long and centrally located myelitis, a linear medullary lesion causing IHN may distinguish NMO from MS.

Intractable hiccup and nausea with periaqueductal lesions in neuromyelitis optica

PURPOSE. Anterior ischemic optic neuropathy (AION) is caused by sudden loss of vascular supply to retinal ganglion cell (RGC) axons in the anterior portion of the optic nerve and is a major cause of optic nerve dysfunction. There has been no easily obtainable animal model of this disorder. The current study was conducted to design a novel model of rodent AION (rAION), to enable more detailed study of this disease. METHODS. A novel rodent photoembolic stroke model was developed that is directly analogous to human AION. Using histologic, electrophysiological, molecular- and cell biological methods, the early changes associated with isolated RGC axonal ischemia were characterized. RESULTS. Functional (electrophysiological) changes occurred in RGCs within 1 day after rAION, with a loss of visual evoked potential (VEP) amplitude that persisted in the long term. The retinal gene expression pattern rapidly changed after rAION induction, with an early (<1 day) initial induction of c-Fos mRNA, and loss of RGC-specific gene expression. RGC-specific protein expression declined 2 days after detectable mRNA level changes, and immunostaining suggested that multiple retinal layers react to isolated RGC axonal ischemia. CONCLUSIONS. rAION rapidly results in electrophysiological and histologic changes similar to clinical AION, with reactive responses in primary and supporting neuronal cell layers. The rAION model can enable a detailed analysis of the individual retinal and optic nerve changes that occur after optic nerve stroke, which may be useful in determining possible therapeutic interventions for this disorder.

Functional and cellular responses in a novel rodent model of anterior ischemic optic neuropathy.

This was to investigate the root canal morphology of primary molar teeth using micro-computed tomography. Primary maxillary (n = 20) and mandibular (n = 20) molars were scanned at a resolution of 16.7 μm and analysed regarding the number, location, volume, area, structured model index (SMI), area, roundness, diameters, and length of canals, as well as the thickness of dentine in the apical third. Data were statistically compared by using paired-sample t test, independent sample t test, and one-way analysis of variance with significance level set as 5 %. Overall, no statistical differences were found between the canals with respect to length, SMI, dentine thickness, area, roundness, and diameter (p > 0.05). A double canal system was observed in the mesial and mesio-buccal roots of the mandibular and maxillary molars, respectively. The thickness in the internal aspect of the roots was lower than in the external aspect. Cross-sectional evaluation of the roots in the apical third showed flat-shaped canals in the mandibular molars and ribbon- and oval-shaped canals in the maxillary molars. External and internal anatomy of the primary first molars closely resemble the primary second molars. The reported data may help clinicians to obtain a thorough understanding of the morphological variations of root canals in primary molars to overcome problems related to shaping and cleaning procedures, allowing appropriate management strategies for root canal treatment.

Root canal morphology of primary molars: a micro-computed tomography study

In this study we wished to determine whether technetium-99m annexin V, an in vivo marker of cellular injury and death, could be used to noninvasively monitor neuronal injury following focal middle cerebral artery (MCA) occlusion/reperfusion injury. Sixteen adult male Sprague-Dawley rats (along with four controls) underwent left (unilateral) MCA intraluminal beaded thread occlusion for 2 h followed by reperfusion. One hour following tail vein injection of 5–10 mCi of 99mTc-annexin V, animals underwent either single-photon emission computerized tomography (SPECT) or autoradiography followed by immunohistochemical analyses. There was abnormal, bilateral, multifocal uptake of 99mTc-annexin V in each cerebral hemisphere as seen by both SPECT and autoradiography at 4 h and 1, 3, and 7 days after initiation of occlusion. The average maximal annexin V uptake at 4 h was 310%±85% and 365%±151% above control values (P<0.006) within the right and left hemispheres, respectively, peaking on day 3 with values of 925%±734% and 1,194%±643% (P<0.03) that decreased by day 7 to 489%±233% and 785%±225% (P<0.01). Total lesional volume of the left hemisphere was 226%, 261%, and 451% (P<0.03) larger than the right at 4, 24, and 72 h after injury, respectively. Annexin V localized to the cytoplasm of injured neurons ipsilateral to the site of injury as well as to otherwise normal-appearing neurons of the contralateral hemisphere as confirmed by dual fluorescent microscopy. It is concluded that there is abnormal bilateral, multifocal annexin V uptake, greater on the left than on the right side, within 4 h of unilateral left MCA ischemic injury and that the uptake peaks at 3 days and decreases by 7 days after injury. This pattern suggests that neuronal stress may play a role in the response of the brain to focal injury and be responsible for annexin V uptake outside the region of ischemic insult.

Detection of focal hypoxic-ischemic injury and neuronal stress in a rodent model of unilateral MCA occlusion/reperfusion using radiolabeled annexin V.

Intractable hiccups are debilitating and are usually a result of underlying disease. A method of treating chronic hiccups is provided, comprising the steps of applying a peripheral nerve stimulator to the vagus nerve at a predetermined frequency, pulse width, amplitude, and duration; monitoring the occurrence of hiccups in response to said stimulation; and adjusting said frequency, pulse width, amplitude, and duration to reduce the occurrence of said hiccups. The vagus nerve stimulation methods disclosed herein have provided complete resolution to date with a patient with intractable hiccups occurring after a posterior fossa stroke.

Vagus nerve stimulation for chronic intractable hiccups

A case of Graves' diseases associated with intracranial moyamoya vessels and tubular stenosis of extracranial internal carotid arteries.

PURPOSE The purpose of this study was to determine the prevalence of 3-rooted primary mandibular second molar teeth in Chinese patients via vertical bitewing radiography. METHODS Vertical bitewing radiographs of 227 patients previously obtained from the Department of Pediatric Dentistry, Taichung Veterans General Hospital, Taichung City, Taiwan, from June 2004 to July 2007 were retrospectively screened and examined. Images of 185 patients (92 boys and 93 girls; mean age=5.6 [range=2.5-11.9] years old) with bilateral primary mandibular second molars were studied. The gender, symmetry, and frequencies of occurrence of 3-rooted primary mandibular second molars were compared. RESULTS Eighteen (9%) 3-rooted primary mandibular second molars were found in the 185 patients, with a bilateral incidence of a symmetrical distribution of 28% (5/18). The prevalence of 3-rooted primary second molars did not differ significantly between the mandible's right and left sides (P<.41), or with gender (P<.31). CONCLUSIONS The data presented here indicate that approximately one tenth of Chinese individuals have a 3-rooted primary mandibular second molar and that this condition is bilaterally symmetric in approximately one third of such individuals in a Taiwan hospital.

Prevalence of 3-rooted primary mandibular second molars among chinese patients.

Intractable hiccup caused by medulla oblongata lesions.

Amphotericin B-induced leukoencephalopathy in a patient with cryptococcal meningitis

Delayed transhemispheric c-fos gene expression after focal cerebral ischemia-reperfusion in rats.

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